Peace of mind: For those concerned about dementia, memory screenings can provide answers

Kevin Stankiewicz More Content Now

Thursday

Mar 21, 2019 at 1:42 PMMar 21, 2019 at 1:42 PM

There isn’t a cure for dementia or Alzheimer’s disease yet, but early detection is vital for proper treatment.Doctors say memory screenings can help diagnose dementia — or provide peace of mind for people who don’t have the disease.People who are concerned about memory loss should ask their doctor for a screening, a test that measures memory and evaluates other cognitive abilities, experts say.Even though the tests don’t provide a diagnosis, they’re the starting point for evaluating people with memory concerns, doctors say.“It’s one small part of our whole assessment — an important piece, but a small piece,” said Dr. Lakshmi Rangaswamy, a geriatrician with OhioHealth’s Gerlach Center for Senior Health.There are different types of memory evaluations. Some ask you to identify what is in a picture, write down the day’s date or answer how many nickels are in 60 cents.If you take a test and score normal, it should put the immediate worry to rest.If you don’t score well, doctors will investigate the results further, Rangaswamy said. It doesn’t automatically mean you have dementia. The memory problems caused by some conditions can be reversed with the right treatment.“If you do all that and don’t find something reversible, then you ask whether this might be a sign of something more,” said Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center. After further evaluation and testing, the problem might be revealed as dementia or Alzheimer’s — undoubtedly a monumental diagnosis but one that is beneficial to learn about as early as possible.“The sooner you understand what you’re facing, the quicker you can treat and be proactive about your care,” said Tricia Bingham, director of programs and services for the central Ohio chapter of the Alzheimer’s Association.Most of the medication used to slow Alzheimer’s disease works best when the disease is at its earliest stages, Bingham said. That’s also the case with other types of dementia.Early diagnosis of Alzheimer’s, dementia or mild cognitive impairment, which is the step between normal aging and more serious dementia, also could make you eligible to enroll in a clinical trial for experimental medications, Petersen said.“It helps that person be involved in managing their own care and getting their financials in order and their advanced directives in order, where they have more control in the decision-making process in their care,” Bingham said. “That would obviously be much harder later when they’re in the middle of the disease or toward the end, where people have to make an assumption of care for someone because they didn’t know what they wanted.”Petersen and other health-care professionals do have some reservations about memory screenings. For Petersen, it comes down to where the screening is being given. He said he doesn’t recommend them outside a formal medical environment and expressed concerns about mass screenings for the public.“We don’t want people to put up kiosks in malls and say, ‘Come on in here and let’s test your memory,’” Petersen said. Those results might not be interpreted correctly — like when someone actually has memory loss due to an underlying condition such as sleep apnea or when someone scores “in the gray zone.”“Do you have the right data to interpret that result and might people become worried or obsessed if they don’t remember as much as they think they ought to?” Petersen said.Dr. Douglas Scharre, a dementia expert at the Ohio State Wexner Medical Center’s Neurological Institute, developed a test that he feels avoids some of the concerns while also increasing access to memory screenings. It’s called the SAGE test, and it’s a self-administered evaluation that can be downloaded online. After taking the test, you’re advised to take it to your physician, who can score and properly interpret the results, Scharre said.Scharre said it’s not the same thing as a general-population screening because people have to choose to download the test.“People seek it out because there is probably some reason for concern,” Scharre said.More people should undergo memory screenings, Bingham said, citing data that nearly half of people who have Alzheimer’s don’t know it.“I understand that it’s a common reaction not to have your memory tested because you’re afraid of the results. There’s a lot of fear and a lot of stigma,” she said. “It’s not necessarily that people are going out and getting evaluated all the time. It’s under-evaluation.”